Speakers praise Valley Regional, Dartmouth Health merger at Claremont event

CLAREMONT — Legislators and hospital workers largely lauded the merger of Valley Regional Hospital and Dartmouth Health, which was finalized last summer, at a forum hosted this week by the New Hampshire Healthcare Consumer Protection Advisory Commission.

They also raised concerns about broader health care issues during the forum, which took place at Claremont Savings Bank Community Center on Wednesday.

“Here in rural New Hampshire, and the valley is rural, we’re seeing a lot less opportunity for small community hospitals to survive in the model that they had in the past, and we need to consider that moving forward,” said Claremont resident Jim Esdon, program coordinator of Dartmouth Health Children’s Injury Prevention Center. “Dartmouth Health brings those resources and that really strong community component to this.”

Established by the New Hampshire Legislature in 2023, the commission holds state proceeds received from the settlements and judgments of health care mergers. The commission, which is part of the New Hampshire Department of Justice, uses the money “for the purpose of benefiting New Hampshire healthcare consumers,” according to its website.

As part of last summer’s merger between Dartmouth Health and Valley Regional, Dartmouth Health agreed to pay $2 million to the state commission.

The Claremont forum, which drew more than 60 people, was the second the commission has held so far, and was a part of its planning process for allocating its resources. The first forum took place in May in Rochester, N.H., where many community members gave testaments about their access to health care decreasing. They also asked for continued conversation with for-profit Hospital Corporation of America, which acquired Rochester’s Frisbie Memorial Hospital in 2020, according to the commission’s draft minutes.

The commission has around $20 million to spend over the next eight to 10 years and wants to direct it toward the issues they find in common among health care consumers across the state, said New Hampshire Attorney General John Formella, a member of the commission.

The commission’s first project was to launch a new research center at the University of New Hampshire to study the impact of mergers on the health care market in the state. Last October, the commission invested $1.6 million into the research center to be used over four years.

As hospitals trend toward consolidation, the state’s attorney general is responsible for enforcing antitrust laws, which seek to prevent monopolies from forming.

“When smaller community hospitals become part of larger health care systems, that can do a number of things,” Formella, a Hanover High School graduate, said. “It can cause competition to go down, it can cause loss of services in the local community, it can cause prices to go up, (but) it can certainly bring benefits as well.”

Those who spoke at the meeting were generally in support of the merger between Valley Regional and Dartmouth Health, which operates nine hospitals and clinics in New Hampshire and Vermont.

“I think that there is a lot that is really promising about this connection between Dartmouth Health and Valley Regional Hospital,” Executive Councilor Karen Liot Hill, D-Lebanon said, citing increased access to Dartmouth Health’s resources for the Claremont area that comes with the merger.

People also spoke about broader issues, including housing, transportation and nutrition.

In a recent assessment of the needs of Dartmouth Health’s five-hospital region in New Hampshire, the clearest issue was “the competition between social needs of life and health care needs,” Greg Norman, senior director of community health at Dartmouth Health, said at the meeting.

The assessment found that access to secure housing, reliable transportation, child care and affordable food have gotten “profoundly, overwhelmingly worse in terms of health in our communities” Norman said.

Liot Hill also suggested that access is a particular challenge for rural communities.

“I am here particularly to advocate for transportation to be something that you consider,” said Liot Hill. She suggested that the Advance Transit model in Lebanon and Hanover, which Dartmouth Health significantly invests in, be adopted for Valley Regional access.

State Rep. Hope Damon, D-Croydon, proposed expanding food security funding and preventive care: “If we made access (to diabetes) treatment more readily available, we would enormously save in preventing complications,” Damon said.

Matthew Foster, CEO of both Valley Regional and Mt. Ascutney Hospital and Health Center in Windsor, emphasized Valley Regional must expand its partnerships to other service providers.

“We have to think beyond the four walls of the hospital if we’re going to improve the health of Sullivan County and Claremont,” Foster said.

Gary Merchant, a former Democratic state representative and former manager of business and technology at Dartmouth Hitchcock, suggested renewing River Valley College’s health programs through the resources of Dartmouth Health.

The health programs, including occupational therapy assistant and licensed practical nurse programs, were once “booming” with an enrollment over 1,000, but were grappling with housing issues at the time, said Chuck Kusselow, the former director of admissions of River Valley Community College and current member of the Advisory Committee for Dartmouth Health’s Geriatric Center of Excellence.

The college discussed building a dorm for the programs, as one of the major issues was students not having a place to stay, Kusselow said.

Formella proposed that the commission could set up housing and/or tuition stipends for such students. “There might be some large medical organization in the area that wants to partner with us on that,” he said, smiling at Dartmouth Health officials.

Largely absent from the event were community members, as most speakers were either people who had worked for the two hospitals or elected officials — many checking both boxes.

Toward the end of the meeting, Formella expressed a desire to hear from more unaffiliated community members.

“I’m mindful of the fact that most people are not going to want to come to a meeting like this and stand at a podium, and talk to us in this format,” Formella said. “And so, that’s one of the takeaways I have from tonight in our future.”

Lukas Dunford can be reached at ldunford@vnews.com or 603-727-3208.